Purpose and procedure

The general purpose of Evidence-Based Nursing is to select from the health related literature those articles reporting studies and reviews that warrant immediate attention
by nurses attempting to keep pace with important advances in their profession. These articles are summarised in “value added”
abstracts and commented on by clinical experts. The specific purposes of Evidence-Based Nursing are:

To identify, using predefined criteria, the best quantitative and qualitative original and review articles on the meaning,
cause, course, assessment, prevention, treatment, or economics of health problems managed by nurses and on quality assurance

To summarise this literature in the form of “structured abstracts” that describe the question, methods, results, and evidence-based
conclusions of studies in a reproducible and accurate fashion

To provide brief, highly expert comment on the context of each article, its methods, and clinical applications that its findings
warrant

To disseminate the summaries in a timely fashion to nurses.

The Royal College of Nursing (RCN) Publishing Company and the BMJ Publishing Group publish Evidence-Based Nursing under the editorship of Dr Alba DiCenso and Dr Donna Ciliska at McMaster University in Canada and Dr Nicky Cullum at the
University of York in the UK. The Health Information Research Unit (HIRU) of the Department of Clinical Epidemiology and Biostatistics
at McMaster University hosts the editorial office for the production of the abstracts and commissioning of commentaries. Dr
Brian Haynes acts as coordinating editor to ensure that methods and procedures are consistent with other evidence-based journals
prepared by HIRU.

Studies of prognosis must meet these additional criteria:

Inception cohort (first onset or assembled at a uniform point in the development of a condition or disease) of individuals,
all initially free of the outcome of interest

Follow up of at least 80% of participants until the occurrence of a major study end point or to the end of the study

Analysis consistent with study design.

Studies of causation must meet these additional criteria:

Clearly identified comparison group for those at risk of, or having, the outcome of interest (ie, randomised, quasi randomised,
or non-randomised controlled trial; cohort analytic study with case by case matching or statistical adjustment to create comparable
groups; case control study)

Blinding of observers of outcome to exposure (criterion assumed to be met if outcome is objective, eg, all cause mortality,
self administered psychometric test)

Blinding of observers of exposure to outcomes for case control studies or blinding of subjects to exposure for all other study designs

Analysis consistent with study design.

Studies of quality assurance must meet these additional criteria:

Random allocation of participants or units to comparison groups

Follow up of at least 80% of participants

Outcome measure of known or probable clinical or educational importance

Analysis consistent with study design.

Studies of the economics of healthcare programmes or interventions must meet these additional criteria:

The economic question must compare alternative courses of action

Alternative diagnostic or therapeutic services or quality assurance activities must be compared on the basis of both the outcomes
produced (effectiveness) and resources consumed (costs)

Evidence of effectiveness must be from a study (or studies) that meets the criteria for treatment, assessment, quality assurance,
or a review article

Results should be presented in terms of the incremental or additional costs and outcomes of one intervention over another

Where there is uncertainty in the estimates or imprecision in the measurement, a sensitivity analysis should be done.

Clinical prediction guides must meet these additional criteria:

The guide must be generated in 1 set of patients (training set) and validated in an independent set of patients (test set)
and must also meet the above noted criteria for treatment, assessment, prognosis, or causation.

Review articles must meet these additional criteria:

A clear statement of the clinical topic being reviewed

A clear description of the sources and methods for identifying articles

Specification of the inclusion and exclusion criteria for selecting articles for detailed review

At least 1 article in the review must meet the above noted criteria for treatment, assessment, prognosis, causation, quality
improvement, or economics of health care programmes.

QUALITATIVE STUDIES

Research topic or question specified

Appropriate research design to address question

Research method described and substantiated

Study participants and context described

Information gathering and analysis appropriate

Data interpretation and conclusions consistent with data analysis.

These criteria are subject to modification if, for example, it becomes feasible to apply higher standards that increase the
validity and applicability of studies for clinical practice. The objective of Evidence-Based Nursing is to abstract only the very best literature, consistent with a reasonable number of articles “making it through the filter”.

Articles meeting the criteria set out above are abstracted according to the procedure for more informative abstracts,1 with these modifications: abstracts are approximately 450 words in length; and each abstract is reviewed by an expert in
the content area covered by the article. This expert writes a commentary in which she or he compares the study findings to
previous research findings, identifies any important methodological problems that affect interpretation of the study results,
and offers recommendations for clinical application. The author of the article is given an opportunity to review the abstract
and commentary before publication.

In the last issue of each year, we will publish a list of articles that passed all criteria but were not abstracted because,
in the judgment of the editors, their findings were less applicable to nursing practice.